Ultrasound medical instrument having a medical ultrasonic blade

ABSTRACT

An ultrasonic medical instrument is disclosed including a single medical ultrasonic blade having a proximal blade portion and a distal blade portion. The proximal blade portion has a first transverse area and the distal blade portion has a second transverse area. The second transverse area is smaller than the first transverse area. The distal blade portion includes at least two longitudinal vibration nodes and is more bendable than the proximal blade portion. A user-actuated articulated sheath surrounding at least a portion of the single medical ultrasonic blade comprises a plurality of support members, each of the support members extending inwardly from the user-actuated articulated sheath and contacting the distal blade portion at one of the at least two longitudinal vibration nodes such that articulation of the user-actuated articulated sheath causes the distal blade portion to articulate at the at least two longitudinal vibration nodes.

CROSS REFERENCE TO RELATED APPLICATION

The present invention is a continuation application claiming priorityunder 35 U.S.C. § 120 to U.S. patent application Ser. No. 13/865,392,titled ULTRASOUND MEDICAL INSTRUMENT HAVING A MEDICAL ULTRASONIC BLADE,filed Apr. 18, 2013, now U.S. Patent Application Publication No.2013/0231691, which is a divisional application claiming priority under35 U.S.C. § 121 to U.S. patent application Ser. No. 12/603,599, titledULTRASOUND MEDICAL INSTRUMENT HAVING A MEDICAL ULTRASONIC BLADE, filedOct. 22, 2009, now U.S. Patent Application Publication No. 2010/0042126,which is a divisional application claiming priority under 35 U.S.C. §121 to U.S. patent application Ser. No. 11/336,274, titled ULTRASOUNDMEDICAL INSTRUMENT HAVING A MEDICAL ULTRASONIC BLADE, filed on Jan. 20,2006, which issued on Nov. 24, 2009 as U.S. Pat. No. 7,621,930, theentire disclosures of which are incorporated herein by reference.

FIELD OF THE INVENTION

The present invention is related generally to ultrasound medicalinstruments, and more particularly to an ultrasound medical instrumenthaving a medical ultrasonic blade.

BACKGROUND OF THE INVENTION

Known ultrasound medical instruments include ultrasonic surgical blades.Ultrasonic surgical instruments are also known which include ultrasonicsurgical shears having an ultrasonic surgical blade (in the form of atitanium rod), a clamping arm operable to open and close toward theblade, a tissue pad attached to the clamping arm, and a device forexerting a clamping force on the clamping arm which creates a clampingpressure on a blood vessel which is positioned between the tissue padand the blade. The result of the ultrasonically-vibrating ultrasonicsurgical blade and the clamping pressure on the blood vessel is acoaptation of the blood vessel (a bringing together of the walls of theblood vessel), a transection (a cutting) of the coaptated blood vessel,and a coagulation (a sealing) of the coaptated cut ends of the bloodvessel. Articulating surgical staplers, scissors, and graspers are alsoknown.

Still, scientists and engineers continue to seek improved ultrasoundmedical instruments having a medical ultrasonic blade.

SUMMARY OF THE INVENTION

A first embodiment of the invention is for an ultrasonic medicalinstrument including a single medical ultrasonic blade having a lengthand including a proximal blade portion having a first proximal portionand a first distal portion and a distal blade portion having a secondproximal portion and second distal portion, the first distal portionconnected to the second proximal portion. The proximal blade portion hasa first transverse area and the distal blade portion has a secondtransverse area. The second transverse area is smaller than the firsttransverse area. The distal blade portion includes at least twolongitudinal vibration nodes and is more bendable than the proximalblade portion. The distal blade portion includes a distal end treatmentportion adapted to contact and ultrasonically treat patient tissue. Theultrasonic medical instrument further includes a user-actuatedarticulated sheath surrounding at least a portion of the single medicalultrasonic blade. The user-actuated articulated sheath includes aplurality of support members, each of the support members extendinginwardly from the user-actuated articulated sheath and contacting thedistal blade portion at one of the at least two longitudinal vibrationnodes such that articulation of the user-actuated articulated sheathcauses the distal blade portion to articulate at the at least twolongitudinal vibration nodes.

A second embodiment of the invention is for an ultrasonic medicalinstrument including a single medical ultrasonic blade having a lengthand including first and second blade portions, the first blade portionincluding at least one longitudinal vibration node, and the second bladeportion including at least two longitudinal vibration nodes. The firstblade portion has a distal end attached to a proximal end of the secondblade portion. The first blade portion has a first transverse area andthe second blade portion has a second transverse area, the firsttransverse area being greater than the second transverse area. Thesecond blade portion is more bendable than the first blade portion andincludes a treatment portion adapted to contact and ultrasonically treatpatient tissue. The ultrasonic medical instrument further includes auser-actuated articulated sheath received over the single medicalultrasonic blade, the user-actuated articulated sheath including a rigidfirst sheath portion contacting the at least one longitudinal vibrationnode of the first blade portion, a flexible second sheath portionincluding a plurality of support members, each of the support membersextending inwardly from the flexible second sheath portion andcontacting the second blade portion at one of the at least twolongitudinal vibration nodes such that articulation of the flexiblesecond sheath portion causes the second blade portion to articulate atthe at least two longitudinal vibration nodes.

A third embodiment of the invention is for an ultrasound medicalinstrument including a medical ultrasonic blade. The medical ultrasonicblade includes a proximal blade portion having a centerline and includesa distal blade portion in contact with the proximal blade portion at asubstantially planar interface. The interface is oriented at a non-zeroangle with respect to a perpendicular to the centerline at theinterface.

Several benefits and advantages are obtained from one or more of theembodiments of the invention. In one example of the first embodiment,the first and second blade portions are rigid, and the second bladeportion is controllably bent during a medical procedure to more easilyaccess a target site in a patient. In one example of the secondembodiment, the proximal blade portion is rigid, and the distal bladeportion is controllably bent during a medical procedure for the distalend portion of the distal blade portion to more easily access a targetsite in a patient to contact and ultrasonically treat patient tissue. Inone example of the third embodiment, relative rotation, about theinterface, of the proximal and distal blade portions articulates thedistal blade portion with respect to the proximal blade portion.

The present invention has, without limitation, application with straightor curved ultrasonic surgical blades, with or without clamping arms, andfurther in hand-activated instruments as well as in robotic-assistedinstruments.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a schematic cross-sectional view of a portion (with thehandpiece and the sheath-articulation control knobs, etc. omitted forclarity) of a first embodiment of an ultrasound medical instrument ofthe invention wherein the second blade portion is substantially ½ of aresonant-longitudinal-wavelength long;

FIG. 2 is view, as in FIG. 1, but of an alternate embodiment of theultrasound medical instrument wherein the second blade portion spansmultiple ½ resonant longitudinal wavelengths;

FIG. 3 is a view, as in FIG. 1, but of only an alternate embodiment ofthe medical ultrasonic blade, wherein the second blade portion is joinedto the first blade portion by a dowel press fit;

FIG. 4 is a view, as in FIG. 3, but of an alternate embodiment of themedical ultrasonic blade, wherein the second blade portion is joined tothe first blade portion by a ball-and-socket type attachment;

FIG. 5 is a schematic cross-sectional view of a portion of a secondembodiment of an ultrasound medical instrument of the invention whichlacks the third blade portion of the embodiment of FIG. 1;

FIG. 6 is a schematic cross-sectional view of a portion of a thirdembodiment of an ultrasound medical instrument of the invention having amedical ultrasonic blade which includes two blade portions having atilted interface, wherein relative rotation of the blade portions causesarticulation of the distal blade portion with respect to the proximalblade portion; and

FIGS. 7 and 8 are side-elevational views, before-and-after-rotation, ofan alternate embodiment of the medical ultrasonic blade wherein theblade portions have areas of removed material.

DETAILED DESCRIPTION OF THE INVENTION

Before explaining the present invention in detail, it should be notedthat the invention is not limited in its application or use to thedetails of construction and arrangement of parts illustrated in theaccompanying drawings and description. The illustrative embodiments ofthe invention may be implemented or incorporated in other embodiments,variations and modifications, and may be practiced or carried out invarious ways. Furthermore, unless otherwise indicated, the terms andexpressions employed herein have been chosen for the purpose ofdescribing the illustrative embodiments of the present invention for theconvenience of the reader and are not for the purpose of limiting theinvention.

It is understood that any one or more of the following-describedembodiments, examples, etc. can be combined with any one or more of theother following-described embodiments, examples, etc.

Referring now to the Figures, in which like numerals indicate likeelements, FIG. 1 illustrates a first embodiment of the invention. Afirst expression of the embodiment of FIG. 1 is for an ultrasoundmedical instrument 10 including a medical ultrasonic blade 12. Themedical ultrasonic blade 12 has a length and includes first, second andthird blade portions 14, 16 and 18. The second blade portion 16 islocated lengthwise between the first and third blade portions 14 and 18,the first blade portion 14 is located proximal the second blade portion16, and the third blade portion 18 is located distal the second bladeportion 16. The first and third blade portions 14 and 18 each have alarger transverse area and the second blade portion 16 has a smallertransverse area. The second blade portion 16 is more bendable thaneither of the first and third blade portions 14 and 18. It is furthernoted that ultrasonic vibration can be any one, or any combination, oflongitudinal, transverse, and torsional vibration.

In one enablement of the embodiment of FIG. 1, the medical ultrasonicblade 12 is a monolithic blade. In one variation, the medical ultrasonicblade 12 includes first and second longitudinal vibration antinodes 20and 22, wherein the first blade portion 14 transitions to the secondblade portion 16 proximate the first longitudinal vibration antinode 20,and wherein the second blade portion 16 transitions to the third bladeportion 18 proximate the second longitudinal vibration antinode 22.

In one application of the embodiment of FIG. 1, the ultrasound medicalinstrument 10 also includes a user-actuated articulated sheath 24 whichsurrounds the medical ultrasonic blade 12. In one variation, the medicalultrasonic blade 12 includes three (meaning at least three) longitudinalvibration nodes 26 located, one each, on the first, second and thirdblade portions 14, 16 and 18. It is noted that one or more additionallongitudinal vibration nodes may, or may not, be present between any oneor two of the three longitudinal vibration nodes 26. In onemodification, the sheath 24 contacts (i.e., directly contacts orindirectly contacts through at least one intervening member 27 such as asilicone intervening member) the first, second and third blade portions14, 16 and 18 at a corresponding one of the three longitudinal vibrationnodes 26. In one example, the sheath 24 includes a rigid first sheathportion 28 contacting the first blade portion 14 at the firstlongitudinal vibration node (the leftmost node 26 of FIG. 1), a flexiblesecond sheath portion 30 contacting the second blade portion 16 at thesecond longitudinal vibration node (the middle node 26 of FIG. 1), and arigid third sheath portion 32 contacting the third blade portion 18 atthe third longitudinal vibration node (the rightmost node 26 of FIG. 1).In one deployment, the sheath 24 has only two articulation positions(i.e., straight and fully articulated). In a different deployment, thesheath 24 has a number of intermediate bent positions between a straightposition and a fully articulated position depending on the number ofenergy efficient curves the blade 12 can be formed to. In onearrangement, such energy efficient curves minimize vibrational energygoing into non-longitudinal vibrational modes.

In the same or a different variation, as illustrated in the alternateembodiment of the ultrasound medical instrument 110 of FIG. 2, themedical ultrasonic blade 112 includes at least two longitudinalvibration nodes 126 located on the second blade portion 116. In onevariation, the sheath 124 contacts (i.e., directly contacts orindirectly contacts through at least one intervening member 127 such asa silicone intervening member) the second blade portion 116 at theat-least-two longitudinal vibration nodes 126. In one modification, thesheath 124 includes two rigid sheath portions 128 and 132 and oneflexible sheath portion 130, wherein the flexible sheath portion 130contacts the second blade portion 116 at at least one of the twolongitudinal vibration nodes 126, and wherein the flexible sheathportion 130 is disposed between the two rigid sheath portions 128 and132. In one example, the two rigid sheath portions 128 and 132 eachcontact the second blade portion 116 at a corresponding one of theat-least-two longitudinal vibration nodes 126.

In one enablement of the application which includes the sheath 24 of theembodiment of FIG. 1, the medical ultrasonic blade 12 includes a fourthblade portion 34 adapted to contact and ultrasonically treat patienttissue, wherein the fourth blade portion 34 is disposed distal of thethird blade portion 18. In one variation, the ultrasound medicalinstrument 10 also includes a user-actuated clamp arm 36 pivotallyattached to the sheath 24 proximate the fourth blade portion 34, whereinthe clamp arm 36 and the medical ultrasonic blade 12 at least in partdefine an ultrasonic surgical shears 38. The tissue pad and clamping armcontrol mechanism have been omitted from FIG. 1 for clarity.

In one employment of the embodiment of FIG. 1, the first and third bladeportions 14 and 18 are essentially rigid. In the same or a differentemployment, the medical ultrasonic blade 12 includes first and secondneck portions 40 and 42 joining, respectively, the first and secondblade portions 14 and 16 and the second and third blade portions 16 and18. In one modification, the medical ultrasonic blade 12 issubstantially cylindrical from the first blade portion 14 to the thirdblade portion 18, wherein the first, second and third blade portions 14,16 and 18 each have a substantially constant diameter, and wherein thediameter of the second blade portion 16 is smaller than the diameter ofeither of the first and third blade portions 14 and 18. In oneillustration, the diameter of the second blade portion 16 is betweensubstantially one and two millimeters, and the diameter of the first andthird blade portions is between substantially three and fivemillimeters. In one choice of materials, the medical ultrasonic blade 12consists essentially of a titanium alloy. In one modification, themedical ultrasonic blade 12 includes first and second longitudinalvibration antinodes 20 and 22, and the first neck portion 40 is disposedproximate the first longitudinal vibration antinode 20 and the secondneck portion 42 is disposed proximate the second longitudinal vibrationantinode 22.

In one construction, as illustrated in the alternate embodiment of themedical ultrasonic blade 212 of FIG. 3, wherein the medical ultrasonicblade 212 is not a monolithic blade, the second blade portion 216 isjoined to the first blade portion 214 by a dowel press fit and is joinedto the third blade portion 218 by a dowel press fit. In oneillustration, the second blade portion 216 consists essentially oftitanium or nitinol. In the same or a different illustration, the lengthof the second blade portion is less than ½ wave (a wave being the lengthof a resonant-longitudinal-wavelength of the medical ultrasonic bladewhich depends essentially on the material of the blade and the frequencyat which it is run) and in one example is less than ⅛ wave. In adifferent construction, as illustrated in the alternate embodiment ofthe medical ultrasonic blade 312 of FIG. 4, wherein the medicalultrasonic blade 312 is not a monolithic blade, the second blade portion316 is joined to the first blade portion 314 by a ball-and-socket typeattachment and is joined to the third blade portion 318 by a dowel pressfit. Other attachments between blade portions are left to those skilledin the art.

Referring again to the Figures, FIG. 5 illustrates a second embodimentof the invention. A first expression of the embodiment of FIG. 5 is foran ultrasound medical instrument 410 including a medical ultrasonicblade 412. The medical ultrasonic blade 412 has a length and includes aproximal blade portion 414 and a distal blade portion 416. The proximalblade portion 414 has a larger transverse area and the distal bladeportion 416 has a smaller transverse area. The distal blade portion 416bends more easily than does the proximal blade portion 414. The distalblade portion 416 includes a distal end portion 444 adapted to contactand ultrasonically treat patient tissue.

In one example of the first expression of the embodiment of FIG. 5, theadditional ½ wave needed to neck up and create the larger diameter endeffector of the embodiment of FIG. 1 is eliminated making it possible toplace the articulation joint closer to the distal end of the ultrasoundmedical instrument.

The enablements, applications, etc. of the embodiment of FIG. 1 and ofthe alternate embodiments of FIGS. 2-4 are equally applicable (withoutthe presence of the third blade portion) to the embodiment of FIG. 5.

Referring again to the Figures, FIG. 6 illustrates a third embodiment ofthe invention. A first expression of the embodiment of FIG. 6 is for anultrasound medical instrument 510 including a medical ultrasonic blade512. The medical ultrasonic blade 510 includes a proximal blade portion514 having a centerline 546 and includes a distal blade portion 518 incontact with the proximal blade portion 514 at a substantially planarinterface 548. The interface is oriented at a non-zero angle withrespect to a perpendicular to the centerline 546 at the interface 548.

In one arrangement of the embodiment of FIG. 6, the non-zero angle has arange from substantially thirty degrees to substantially sixty degrees.In one variation, the non-zero angle is substantially forty-fivedegrees.

In one enablement of the embodiment of FIG. 6, the proximal and distalblade portions 514 and 518 each have a shape of a substantially solidcircular cylinder. In a different enablement, as shown in the alternateembodiment of FIGS. 7 and 8, the proximal and distal blade portions 614and 618 each have a shape of a substantially solid circular cylinderhaving at least one area 650 and 652 of removed (surface and/ornon-surface) material, wherein the medical ultrasonic blade 612 has anunarticulated position (see FIG. 7) and a fully articulated position(see FIG. 8), and wherein the at-least-one areas 650 and 652 of theproximal and distal blade portions 614 and 618 are substantiallyrotationally opposed about the centerline 646 in the unarticulatedposition and are substantially rotationally aligned about the centerline646 in the fully articulated position. In one example, relative180-degree rotation, about the interface 648, of the proximal and distalblade portions 614 and 618 articulates the distal blade portion 618 withrespect to the proximal blade portion 614 portion from the unarticulatedposition to the fully articulated position. In one application, in theunarticulated position the substantially rotationally opposed areas 650and 652 balance the medical ultrasonic blade 612, and in the fullyarticulated position the substantially aligned areas balance the bladeasymmetry, as can be understood by those skilled in the art.

It is within the ordinary level of skill of the artisan to employmechanisms (such as those employed in conventional flexible endoscopes,articulating surgical staplers, articulating surgical scissors and/orarticulating surgical graspers, and the like) to bend or rotate theappropriate blade portion or portions of the above-described embodimentsof ultrasound medical instruments to articulate the medical ultrasonicblade, when manual bending or rotation during a medical procedure is notdesired.

Several benefits and advantages are obtained from one or more of theembodiments of the invention. In one example of the first embodiment,the first and second blade portions are rigid, and the second bladeportion is controllably bent during a medical procedure to more easilyaccess a target site in a patient. In one example of the secondembodiment, the proximal blade portion is rigid, and the distal bladeportion is controllably bent during a medical procedure for the distalend portion of the distal blade portion to more easily access a targetsite in a patient to contact and ultrasonically treat patient tissue. Inone example of the third embodiment, relative rotation, about theinterface, of the proximal and distal blade portions articulates thedistal blade portion with respect to the proximal blade portion.

While the present invention has been illustrated by a description ofseveral embodiments, it is not the intention of the applicants torestrict or limit the spirit and scope of the appended claims to suchdetail. Numerous other variations, changes, and substitutions will occurto those skilled in the art without departing from the scope of theinvention. For instance, the ultrasound medical instruments haveapplication in robotic assisted surgery taking into account the obviousmodifications of such systems, components and methods to be compatiblewith such a robotic system. It will be understood that the foregoingdescription is provided by way of example, and that other modificationsmay occur to those skilled in the art without departing from the scopeand spirit of the appended Claims.

What is claimed is:
 1. An ultrasonic medical instrument comprising asingle medical ultrasonic blade having a length and including a proximalblade portion having a first proximal portion and a first distal portionand a distal blade portion having a second proximal portion and seconddistal portion, the first distal portion connected to the secondproximal portion, wherein the proximal blade portion has a firsttransverse area and the distal blade portion has a second transversearea, wherein the second transverse area is smaller than the firsttransverse area, wherein the distal blade portion comprises at least twolongitudinal vibration nodes and is more bendable than the proximalblade portion, wherein the distal blade portion includes a distal endtreatment portion adapted to contact and ultrasonically treat patienttissue; and a user-actuated articulated sheath surrounding at least aportion of the single medical ultrasonic blade, the user-acuatedarticulated sheath comprising a plurality of support members, each ofthe support members extending inwardly from the user-actuatd articulatedsheath and contacting the distal blade portion at one of the at leasttwo longitudinal vibration nodes such that articulation of theuser-actuated articulated sheath causes the distal blade portion toarticulate at the at least two longitudinal vibration nodes.
 2. Theultrasonic medical instrument of claim 1, wherein the proximal bladeportion transitions to the distal blade portion proximate a longitudinalvibration antinode.
 3. The ultrasonic medical instrument of claim 1,wherein the user-actuated articulated sheath includes a rigid firstsheath portion contacting a longitudinal vibration node of the proximalblade portion and a flexible second sheath portion contacting alongitudinal vibration node of the distal blade portion.
 4. Theultrasonic medical instrument of claim 1, wherein the single medicalultrasonic blade includes a first neck portion joining the proximal anddistal blade portions, wherein the single medical ultrasonic blade issubstantially cylindrical from the proximal blade portion to the distalblade portion, wherein the proximal and distal blade portions each havea substantially constant diameter, and wherein the diameter of thedistal blade portion is smaller than the diameter of the proximal bladeportion.
 5. The ultrasonic medical instrument of claim 1, wherein theproximal blade portion is essentially rigid.
 6. The ultrasonic medicalinstrument of claim 1, wherein: the proximal blade portion comprises afirst area having a third transverse area, the third transverse areabeing smaller than the first transverse area; the distal blade portioncomprises a second area having a fourth transverse area, the fourthtransverse area being smaller than the second transverse area; the firstarea and the second area are rotationally opposed about a centerline ofthe single medical ultrasonic blade in an unarticulated position of thesingle medical ultrasonic blade; and the first area and the second areaare rotationally aligned about the centerline in an articulated portionof the single medical ultrasonic blade.
 7. An ultrasonic medicalinstrument comprising: a single medical ultrasonic blade having a lengthand including first and second blade portions, the first blade portionincluding at least one longitudinal vibration node, and the second bladeportion including at least two longitudinal vibration nodes, wherein thefirst blade portion has a distal end attached to a proximal end of thesecond blade portion, wherein the first blade portion has a firsttransverse area and the second blade portion has a second transversearea, the first transverse area being greater than the second transversearea, and wherein the second blade portion is more bendable than thefirst blade portion and comprises a treatment portion adapted to contactand ultrasonically treat patient tissue; and a user-actuated articulatedsheath received over the single medical ultrasonic blade, theuser-actuated articulated sheath including a rigid first sheath portioncontacting the at least one longitudinal vibration node of the firstblade portion, a flexible second sheath portion comprising a pluralityof support members, each of the support members extending inwardly fromthe flexible second sheath portion and contacting the second bladeportion at one of the at least two longitudinal vibration nodes suchthat articulation of the flexible second sheath portion causes thesecond blade portion to articulate at the at least two longitudinalvibration nodes.
 8. The ultrasonic medical instrument of claim 7,wherein: the first blade portion comprises a first area having a thirdtransverse area, the third transverse area being smaller than the firsttransverse area; the second blade portion comprises a second area havinga fourth transverse area, the fourth transverse area being smaller thanthe second transverse area; the first area and the second area arerotationally opposed about a centerline of the single medical ultrasonicblade in an unarticulated position of the single medical ultrasonicblade; and the first area and the second area are rotationally alignedabout the centerline in an articulated portion of the single medicalultrasonic blade.